Nurse-led development of a rapid-access clinic and referral pathway for suspected inflammatory bowel disease

Abstract

Inflammatory bowel disease (IBD) can have a similar presentation to irritable bowel syndrome, microscopic colitis and other differential diagnoses. Making a diagnosis is complex and typically involves multiple stages, including faecal calprotectin (FC) testing. In 2016, a rapid-access clinic and referral pathway for suspected IBD was developed by an IBD clinical nurse specialist to decrease the time from referral to diagnosis, reduce emergency admissions and outpatient referrals and improve patient experience. Over an 18-month period, a retrospective quantitative evaluation of 400 patients and small survey of 10 patients confirmed that the rapid-access clinic had had a positive impact on outcomes and that the service was sustainable. The results also led to a revision of the referral pathway, which raised the initial FC cut-off point and provided additional information for primary care professionals. This led to a small increase in the proportion of referrals that led to an IBD diagnosis, from 28% to 32%. The rapid-access clinic demonstrated the value of service development led by IBD nurses.